Severe miliary tuberculosis co-infected with cytomegalovirus infection: A case report

Szu Huei Su, Wen Laing Yu

Research output: Contribution to journalArticle

Abstract

Cytomegalovirus (CMV) Infection occurs in 0 to 36% of critically III patients, mostly between 4 and 12 days after Intensive care units (ICUs) admission. Research reported that the ICU stay and mechanical ventilation days of the critically ill patients with CMV infections were longer than those without CMV infections. Studies have suggested that immunocompromised patients such as cancer patients, organ transplant recipients and acquired immunodeficiency syndrome with positive CMV- polymerase chain reaction (PGR) results should be early initiated with antl-CMV therapy to reduce mortality. However, it remains controversial to treat the ICU patients without Immunosuppression when the CMV-PCR results were positive. The 74 years old man was brought to the Emergency Room of the hospital due to fever and short of breath. He was intubated for acute respiratory failure and was admitted to the ICU. The CXR showed diffuse miliary lesions over bilateral lung fields. The acid-fast bacilli stain and tuberculosis (TB)-PCR of the sputum both showed positive, so he was mainly given anti-TB therapy. But the patient continued with instability of oxygen saturation, and bilateral pneumonia has not improved. Meanwhile, the CMV-PCR of the sputum and blood showed positive, thus active CMV infection was suspected and ganciclovir infusion was Initiated. But afterS days of ganciclovir therapy, the patient still passed away. We recognized a difficult-to-treal case while facing such a severely life-threatening Illness, therefore, we remind the possible co-infection of milary tuberculosis and CMV infection and suggest a trial of early diagnosis and early initiation of therapy to control progressive worsening of CMV Infection, In order to cure the illness.

Original languageEnglish
Pages (from-to)220-226
Number of pages7
JournalJournal of Internal Medicine of Taiwan
Volume24
Issue number3
Publication statusPublished - Jun 2013

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Miliary Tuberculosis
Cytomegalovirus Infections
Cytomegalovirus
Intensive Care Units
Polymerase Chain Reaction
Ganciclovir
Tuberculosis
Sputum
Immunocompromised Host
Secondary Prevention
Coinfection
Artificial Respiration
Critical Illness
Respiratory Insufficiency
Immunosuppression
Bacillus
Hospital Emergency Service
Early Diagnosis
Pneumonia
Acquired Immunodeficiency Syndrome

ASJC Scopus subject areas

  • Internal Medicine

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Severe miliary tuberculosis co-infected with cytomegalovirus infection : A case report. / Su, Szu Huei; Yu, Wen Laing.

In: Journal of Internal Medicine of Taiwan, Vol. 24, No. 3, 06.2013, p. 220-226.

Research output: Contribution to journalArticle

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